Multicenter Clinical Trial to Evaluate the Safety and Feasibility of an Allogeneic Tissue Engineered Drug (Nanostructured Artificial Human Cornea) in Patients With Corneal Trophic Ulcers Refractory to Conventional Treatment
试验速览
- 阶段
- 1 期
- 状态
- 已完成
- 发起方
- 入组人数
- 16
- 试验地点
- 11
- 主要终点
- Local, regional or systemic infections related with the implant
研究概览
简要总结
This is a prospective, phase I-II, randomised, open-label clinical trial that will evaluate the safety and feasibility, as well as clinical efficacy evidence, of a bioengineered anterior corneal substitute in adults with severe trophic corneal ulcers. This model of human anterior allogeneic cornea will provide an alternative approach in cases where human donor keratoplasty is not an option.
详细描述
This is a phase I-II, randomised, controlled, open-label clinical trial, currently ongoing in eleven Spanish hospitals, to evaluate the safety and feasibility, as well as clinical efficacy evidence, of a bioengineered human anterior corneal substitute in adults with severe trophic corneal ulcers refractory to conventional treatment, or with sequelae of previous ulcers. In the initial phase of the trial (n=5), patients were sequentially recruited, with a safety period of 45 days, receiving the bioengineered corneal graft. In the second phase of the trial (currently ongoing), subjects are block randomised (2:1) to receive either the corneal graft (n=10), or amniotic membrane (n=5), as the control treatment. Adverse events, implant status, infection signs and induced neovascularization are evaluated as determinants of safety and feasibility of the bioengineered graft (main outcomes). Study endpoints are measured along a follow-up period of 24 months, including 27 post-implant assessment visits according to a decreasing frequency. Intention to treat, and per protocol, and safety analysis will be performed.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Man or woman aged≥18, with no upper age limit.
- •Patients that give their informed consent for study participation.
- •Stage 3 Mackie corneal ulcers that do not respond to conventional medical treatment, or patients having undergone previous stage 3 Mackie corneal ulcers,33 currently suffering sequelae such as stromal fibrosis or corneal thinning, having no effective therapeutic alternative.
- •Stromal involvement, not reaching the Descemet membrane. Central or peripheral localization.
- •Minimum duration of the disease causing the corneal ulcer: 6 weeks.
- •No active ocular infection.
- •Patients with normal laboratory parameters as defined by: Leukocytes≥3000 cells/µL; Neutrophils≥1500 cells/µL; Platelets≥100 billion/L; AST/ALT≤1.5 ULN; Creatinine≤1.5 mg/dL.
排除标准
- •Absence of stromal involvement.
- •Good response to standard medical treatments for corneal disease in less than 3 to 5 weeks.
- •Bullous keratopathy or other endothelial decompensations.
- •Active ocular infection.
- •Positive serology to HBV, HCV, HIV or any other pathology that may interfere with correct patient follow-up.
- •Pregnant or breast-feeding women or childbearing-age women that do not consent the use of contraceptive methods approved in the protocol.
- •Medical history of active neoplasia within the past 5 years. Participation in other clinical trials in 3 months previous to inclusion, or in the previous 5 years for trials with advanced therapies.
研究组 & 干预措施
Anterior lamellar nanostructured artificial human cornea
Anterior lamellar nanostructured artificial human cornea with allogenic from dead donor and cultured in its inside and allogeneic corneal epithelium cultured in its surface
干预措施: Anterior lamellar nanostructured artificial human cornea. (Drug)
Amniotic membrane transplantation
Amniotic membrane transplantation as conventional treatment of corneal trophic ulcers.
干预措施: Amniotic membrane transplantation (Other)
结局指标
主要结局
Local, regional or systemic infections related with the implant
时间窗: 24 months
Adverse events (and serious adverse events) causally related to experimental treatment.
时间窗: 24 months
Implant status (integrity, detachment and reabsorption)
时间窗: 24 months
Induced corneal neovascularization
时间窗: 24 months
次要结局
- Visual acuity(24 months)
- Corneal transparency(24 months)
- Tear function (TBUT and Schirmer)(24 months)
- Ulcer persistency or relapse and corneal stromal repair(24 months)
- Quality of life (EQ-5)(24 months)
- Induced chronic ocular complications(24 months)
- In vivo confocal microscopy (IVCM) analysis of the grafted bioengineered cornea (and AM)(24 months)